Female hormone blocks HIV in men

Australian researchers have discovered that an off-the-shelf cream could be used to block the transmission of HIV in men.

The University of Melbourne study, published today in PLoS One, has found that a cream containing the female hormone oestriol helps block HIV penetrating the inner foreskin of the penis.

According to Professor Roger Short, from the university's Faculty of
Medicine, Dentistry and Health Sciences, the finding is significant,
because the inner foreskin of the penis is where HIV enters the male
body.

According to the researchers, Langerhans cells, which are found in
the inner foreskin, form part of the body's natural defence against HIV
infection. But if large amounts of HIV are present, the Langerins cells
can act as vectors for transporting the virus to the regional lymph
nodes.

"It gets through the inner foreskin where you have all these
Langerhans cells, [which] are like octopuses lying in the epithelium
with tentacles reaching up to the epithelial surface, which have
receptors for HIV," Short says.

"If an HIV virion comes along, it binds to one of these tentacles and the octopus pulls it in and migrates into the lymphatics."

The researchers found that keratin acts as a barrier protecting Langerhans cells and preventing HIV from entering the body.

As part of the study, oestriol cream was applied to the inner
foreskin of subjects and contact smears were collected to measure the
level of keratin in the region.

The results showed that the cream produced a highly significant
increase in the number of keratinised cells within 24 hours of
treatment, and lasted for at least five days after the treatment
stopped.

"This thickening of the overlying protective layer of keratin should
reduce the exposure of the underlying Langerhans cells to HIV virions,"
Short says.

Healing qualities

Previous studies have also
shown that circumcision halves the risk of HIV infection, because it
removes Langerhans cells, which are abundant in the inner foreskin.

But, Short says there have been reports of men not waiting for their
circumcision wounds to heal, placing them at greater risk of HIV
infection.

He believes the use of oestriol cream will speed up the healing process, without any side-effects.

"We are currently undertaking a trail looking to see how effective
the oestrogen cream is at wound healing after circumcision," Short says.

"The cream that we are using has been used by millions of women for
the last 30 years as a standard treatment for post-menopausal vaginal
atrophy."

Cultural alternative

The researchers believe
oestriol cream could become an alternative to circumcision in countries
like India, China and most of South-East Asia where circumcision is
culturally unacceptable.

"Oestrogen cream could even be used as a condom lubricant that might
ultimately protect the man and the woman," the researchers write.

Short admits it's still early days, but is excited by the study's findings.

"The very fact the World Health Organisation has responded to me with 'wow' is pretty exciting."

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